The invention relates to a temporary wound closure for intracorporeal use; i.e. use within the body.
In surgery wounds may have to be closed only temporarily. For example, in the case of diffuse purulent peritonitis the abdominal cavity must be regularly flushed out with a disinfecting solution, for example, a chloramine solution, whereafter the wound is closed only provisionally with rough stitches or gauzes until the next flushing. Staged washing therapy of that kind is able to reduce the mortality rate of diffuse purulent peritonitis, which is today still very high, to about 20%.
Temporary wound closures are also required with the decomposition of the pancreas, when under certain conditions the pancreas may gradually become necrotic. Since the necrotic tissue must be removed immediately, the abdomen is conveniently opened on each occasion within a number of periods of time, to give the patient a better chance of survival.
Finally, intracorporeal temporary wound closures are always advantageous if there is a suspicion that postoperational difficulties may occur.
More particularly in the case of washing at intervals, an attempt has been made to sew ordinary zip fasteners after sterilization into the human body as a temporary wound closure.
There is the risk that body fluid may emerge through the individual teeth of the zip fastener, or that body tissue will get jammed and damaged between the teeth of the fastener. Moreover, the narrow edges of ordinary zip fasteners cannot be satisfactorily sewed to the adjacent tissue, and since moreover the fastener must be sewn in the open condition, it cannot always be correctly aligned and adequately closed.
While fasteners have been developed, such as described in U.S. Pat. No. 2,665,467, which do not have individual teeth as does the common zip fastener, these fasteners are still not suitable for intracorporeal use. These fasteners still cannot be adequately attached to adjacent tissue and still do not provide the desired hermetic seal for intracorporeal use. Furthermore, while there are not individual teeth on which tissue can be caught, the profiled closing strips still may engage and damage tissue during the closing of the wound and fastener.
In some surgical dressings, for example, as shown in U.S. Pat. No. 2,012,755, developments have been made to prevent the fastener from damaging the skin. In this patent a plastic strip is placed beneath the zig fastener to prevent the pinching of skin r tissue when the fastener is opened and closed. However, such surgical dressings are not suitable for intracorporeal use because it is desired that they not form a hermetic seal but, in fact, allows for drainage of the wound. Furthermore, such dressings are not sutured or sewn to the adjacent tissue but are usually applied with a pressure sensitive adhesive. The use of a pressure sensitive adhesive intracorporeal is not desired for a number of reasons, such as lack of bio-compatibility and failure to provide the desired adhesive to body tissue when placed in the intracorporeal environment.
Other zip fasteners such as, for example, those of divers' suits, would in fact theoretically produce a hermetic closure, but they are too heavy and also have the aforementioned disadvantages when sewn in open.
Furthermore, standard types of adhesive surgical dressings which are used on the skin or outside the body are unsatisfactory for intracorporeal use for a number of reasons. Such closures do not always provide a leak-proof seal, are difficult to align longitudinally and most importantly cannot be readjusted in order to compensate for the swelling and/or shrinkage of a traumatized portion of the human body. Also, such adhesive surgical dressings suffer from lack of desired bio-compatibility and failure to provide assured adherence to tissue intracorporeally.
It is an object of the invention to provide a temporary wound closure for intracorporeal use which is bio-compatible, which can be very simply connected to the fascia or abdomen covering, can be connected to tissue with the desired assured correction, can be so connected a number of times, causes no damage to the tissue, can be sewn in open, has closure zones sliding against one another, provides for longitudinal alignment and is fluid-tight.